The pharmaceutical industry has gotten plenty of (well deserved) bad press for its pricing practices. At the extreme are people like “Pharma Bro” (and convicted felon) Martin Shkreli, who hiked the price of an important medication to treat infections in AIDS patients by over 5000%. But high and rising prices are the norm in pharma. New cancer drugs routinely cost more than $100,000 per patient, even when they bring only modest benefits. And some generic medications are going up in price rapidly, 10% or more per year, as the number of generic manufacturers declines.

But it’s not the pharmaceutical industry I’m worried about today.

What about insurance companies? They, too, are routinely criticized for high prices. Premiums continue to rise faster than inflation. And while Americans struggle to find affordable plans, leading insurance company executives report staggeringly high annual incomes. Since passage of the Affordable Care Act, David Cordani, CEO of Cigna, has taken home more than $140 million of compensation. Yet he feels poor compared to Stephen Hemsley, the CEO of UnitedHealthGroup, who has made almost $300 million.

But it’s not insurance companies that are making me anxious right now.

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